1. Meeting with EG PHC
Ev. underrubrik
Förnamn Efternamn

2. Indicator Based Evaluations of National Guidelines

3. Our model to develop good healthcare and social services
Problem analysis
Common terms and
information structure
Best available knowledge
Results
Good healthcare and social services for the entire population
Guidelines
Recommen- dations
Indicators
Targets
Statistics
Follow up
Evaluation
Regulations
Healthcare and social services at local and regional level
The model for developing good health, healthcare and social services

4. Aim of National Guidelines
Indicate the benefits and risks of different interventions to support evidence-based practice in health care
Support professionals in prioritizing the most appropriate interventions for those with the greatest need
Contribute to efficient use of health care resources, distributed according to need, and governed by systematic and transparent priority setting.

5. National Guidelines consist of:
Support for governance and management
Key recommendations
Assessments of the recommendations’ financial and organizational consequences
A list of conditions and interventions for all recommendations
Indicators and target levels (follow-up tools)
Evidence base
Published on the NBHW’s website

6. Indicators

7. Indicators Based on key recommendations in the National Guidelines
Used for:
Assessments of compliance to National Guidelines
As tools for performance assessments
Monitoring and evaluating processes and outcome of care over time
Improving quality and efficiency of health care and social services

8. Types of indicators Organizational indicators – reflect conditions
E.g. number of available specialized diabetes nurses per patient
Process indicators – reflect ”what, when, how and why”
E.g. proportion of patients that receive counseling for smoking cessation
Outcome indicators – reflect results
E.g. proportion of patients that quit smoking following counseling for smoking cessation

9. Formulation of an indicator – example Diabetes care
Wanted: Proportion of diabetes patients with a blood pressure < 140/85 mmHg Numerator: Number of patients with diabetes registered in the National Diabetes registry with a blood pressure < 140/85 mmHg Denominator: Total number of patients with diabetes with registered blood pressure values in the National Diabetes registry

10. Target levels

11. Target levels for indicators in National Guidelines
Important tool for quality improvement
Indicate the proportion of a particular patient group that ought to be subject to a specific recommended treatment or intervention
County councils and municipalities are expected to work towards reaching the targets

12. Determination of target levels
A standardised procedure is used
Expert committee needed to draft a proposal
Ask for opinions among stakeholders:
Head of councils
Patient organisations
Health care professionals
Experts, specialists
Others
Decision by the National Board for Health and Welfare

13. For BP in Type 1 diabetes patients
Target level set to ≥ 90 procent
Target level ≥ 90%
Blood pressure < 140/85 mmHg, Type 1 diabetes
Proportion of persons with Type 1 diabetes with a blood pressure < 140/85
Source: National Diabetes Register

14. Performance assessment

15. Performance assessments
To improve the quality and the efficiency of health care and social services
To assess equality of care with the aim to monitor if patients receive good quality care regardless of their geographic location, gender, age, educational level and country of origin
Tools: National Guideline indicators and target levels

16. The performance assessment suggests that…
Considerable variation
Large gap between actual and optimal level of care
Target level ≥ 90%
Blood pressure < 140/85 mmHg, Type 1 diabetes
Proportion of persons with Type 1 diabetes with a blood pressure < 140/85
Source: National Diabetes Register

17. The recommendation issued to the health services
Health care and medical services can improve the diabetes care by:
Reducing the proportion of patients with type 1 and type 2
diabetes that have a blood pressure over 140/85 mmHg

18. Available performance assessments
2009
2010
2011
2013
2014
2015
Available assessments
Cardiac care (av. in English, 2009)
Breast, prostate or colorectal cancer
Musculoskeletal diseases, (av. in
English, 2014)
Asthma and COPD
Diabetes (av. in English, 2012)
Psychiatric diseases
Dental care
Stroke (av. in English, 2011)
Depression, anxiety and schizophrenia
Dementia
Disease prevention
Ongoing
Cardiac care up(date)
Lung cancer
Palliative care
MS and Parkinson's disease
Currently 11 performance assessments available
4 more ongoing
Ambition to update the assessments within 2-4 years

19. Aim of the workshop - Follow up
Share information on methods and indicators used in partner countries - What, why and how we measure PHC
Find out similarities and differences between our countries as a basis for coming discussions
Find out opportunities to learn from each other and to develop methods and tools together
Inspire a discussion on how EG PHC can support primary health care in the Nordic Dimension.
x/x/20xx

20. Template for primary health indicators
Bildtext